Organization
LIFE ENHANCEMENT SERVICES OF MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT A GRAY (CEO/MANAGING MEMBER)
(202) 269-2401
Entity
Organization
Contact information
Practice address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(202) 269-2401
(202) 269-2403
Mailing address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(202) 269-2401
(202) 269-2403
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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